Posted on 08/29/2011 3:31:56 PM PDT by SmithL
A group of 477 individuals costs The City more than $20 million in emergency medical services in one year — 10 of whom racked up ambulance, emergency, detox and crisis psychiatric services to the tune of $2.3 million.
Those figures have been compiled as part of a new Department of Public Health initiative to get a better handle on San Francisco’s most hardcore homeless population — individuals dubbed “high users of multiple systems” who in many cases suffer from debilitating psychiatric or medical diseases, and typically have severe dependence on alcohol or drugs.
The information about this population was unavailable until the past few years, when Public Health began gathering all the data it collects on clients into a single database, said Maria X. Martinez, assistant to the director of health.
To be counted among this group of high users of multiple systems, an individual must repeatedly need at least two of The City’s four emergency services: ambulances, hospitalization, detox or sobering centers, or emergency mental health services, she said.
In an analysis of data from July 2009 through June 2010, Martinez identified 477 individuals who used at least two of the services regularly; 62 used all four services regularly. Over the course of the year, 34 of them died. All had recently been homeless.
Martinez says understanding the chaos these individuals face in their lives will help Public Health better handle their treatment and contain costs.
“No matter how you cut it, these are expensive patients,” she said. “It’s one of those things where 20 percent of your patients take up 80 percent of your time.”
The City’s Homeless Outreach Team has begun seeking out these high service users, said Dr. Rajesh Parekh, director of the team.
“There’s literally times we find them close to death on the streets, and the first order of business is to get them to the emergency room because we need to save their lives,” he said.
Once they are medically stabilized, the team tries to help them find services. Sometimes, this means simply helping these patients find a primary-care doctor, fill out Social Security income forms, and get the right medication, Parekh said.
“For some people, if you take care of the medical or mental health problems, other things start to get better.”
Parekh acknowledged there are many failures as well. Many in this population are extremely resistant to services. But with patience and perseverance, even they can slowly be won over.
He pointed to paranoid schizophrenics they sometimes run into who believe that everyone they speak to is a government agent out to get them. Outreach workers keep showing up and talking to these people, slowly building trust until they begin to accept some help.
“After a while they say, ‘I still think you’re with the FBI, but maybe you’re not a bad FBI agent, you’re one of the nice ones,’” he said.
Rather than constantly rescuing The City’s most-severely disabled alcohol abusers from the street, some have questioned whether it would be better to provide them a stable source of housing — and a stable source of booze.
This concept, dubbed “wet housing,” has already become reality in Seattle and New York. The idea is to take the folks who are the largest drain on the emergency response system and put them in housing, where at minimum they can live in a safe place off the streets, receive three meals a day, and receive medical treatment. Tenants are allowed to continue their alcohol and drug intake, and in some cases staff even provides alcohol to the tenants like medicine. In Seattle, this program saved a few million dollars a year, and had some success in eventually rehabilitating the tenants — or at least helping them drink less.
Last year, then-Supervisor and now mayoral candidate Bevan Dufty floated a similar project in San Francisco; he said he proposed it to then-Mayor Gavin Newsom, who was interested in the idea but “a little wary of what the public reaction would be.”
Now Dufty has proposed a wet housing project as part of his platform for mayor. He sees the project serving about 200 clients, perhaps in a renovated building.
Dufty said it could vastly improve the experience of both the clients and the average San Francisco resident or tourist, who he said would see a notable decrease of gravely disabled inebriates in the streets.
“This could be an amazing success in the sense that these people are not injuring themselves, not dragging down a business district, not tying up the sobering center and emergency room and jail,” he said.
A Department of Public Health study of individuals who frequently use at least two of The City’s four emergency services — ambulances, emergency treatment at a hospital, mental health crisis services, or detox/sobering services. This study took place between July 2009 and June 2010.
47.8: Average age of the 477 frequent users
75: Percentage who were men
257: Homeless for more than 10 years
477: Frequent users of at least two of the four emergency services
65: People who overlapped in all four systems
332: People who overlapped in at least three systems
0: No documented history of homelessness
34: Died during the course of the year
Source: San Francisco Department of Public Health
Here is the cost breakdown of the 477 highest users of emergency services.
| 5 | More than $200,000 | |
| 29 | $100,001-$200,000 | |
| 83 |
|
$50,001-$100,000 |
| 171 | $25,001-$50,000 | |
| 126 | $15,00 -$25,000 | |
| 63 |
|
$5,001-$15,000 |
| 0 | Less than $5,000 |
One way bus tickets to Los Angeles would have been a lot cheaper.
That sounds like half the population of SF.
The kindest you can do for hardcore street folk is put them away in mental instotutions.
Nice statistics, however, what is your solution to the problem. Should SF simply let these people die? Maybe institutionalize them, the cost would be cheaper in the long run but of course that would be illegal. At any rate, don’t just complain about it come up with a solution or shut up about it. SF(and I hate that town)isn’t the only place to have problems like this.
Nice statistics, however, what is your solution to the problem? Should SF simply let these people die? Maybe institutionalize them, the cost would be cheaper in the long run but of course that would be illegal. At any rate, don’t just complain about it come up with a solution or shut up about it. SF(and I hate that town)isn’t the only place to have problems like this.
I say buy them a private island to retire to and make them go there without any communication allowed, just make them disappear like a witness protection program.
It would be cheaper.
The solution is obvious. Just put them on welfare, in a housing project, food stamps and on Medicare.</sarc>
So the paranoid schizophrenics are worried that government agents might be after them? Why? Are they making guitars? Maybe they’re not so sick after all.
Another horrible liberal contradiction:
Spending millions to keep people from basically voluntarily killing themselves slowly while protesting and screaming for the right to force people who are not trying to kill themselves to be euthanized.
Liberals need to read up on subintentional suicide. If they had any intellectual integrity at all, they would be consistent and bring these homeless people in and "help" them finish themselves off without all the drama, agony and expense to the taxpayer.
But, no, Libs want to kill grandma because they view her as a burden on society if she consumes another few weeks of medical care before expiring naturally.
Another horrible liberal contradiction:
Spending millions to keep people from basically voluntarily killing themselves slowly while protesting and screaming for the right to force people who are not trying to kill themselves to be euthanized.
Liberals need to read up on subintentional suicide. If they had any intellectual integrity at all, they would be consistent and bring these homeless people in and "help" them finish themselves off without all the drama, agony and expense to the taxpayer.
But, no, Libs want to kill grandma because they view her as a burden on society if she consumes another few weeks of medical care before expiring naturally.
So who needs Obamacare?
These people are killing themselves slowly, i.e., committing suicide (if sometimes subintentionally), and Libs are all for "assisted" "suicide" and euthanasia.
Why are Libs forcing these people to stop trying to kill themselves? Is that what Libs stand for -- forcing people who, at some level, want to die to live instead?
Libs are all for killing people who in no way ask to or want to be killed (even if you don't count the unborn in that number -- I do -- there are a vast number of situations in which Libs advocate that people should be killed (euthanized) or "helped" to kill themselves ("assisted suicide").
Yet here they take a group of people who demonstrate MUCH more clearly that they do indeed want to die or, at the least, prefer to live in a way that shortens their life, and Libs are out there forcing them over and over again into staying alive.
Finally, it's not enough to say that institutionalization is not a solution because it's illegal. The laws on these matters should be changed if they are not working.
Maybe the "wet house" model is a solution that works for everyone (it allows the people who want to to kill themselves at their own pace while keeping them off the streets and off the taxpayer tab)?
Back in the “Good Old Days” (before jimmah cahtuh) these types populated hospitals for the insane because they truly are. Then a bunch of do-gooder red-diaper-doper-baby lawyers got their hospitalization declared a violation of their “rights” and got them booted onto the street.
The “homeless” street people were all the fault of Ronaldus Magnus and the evil republicans.
Since these morons in san fransicko supported this the results are exactly what would be expected. More unintended (?) consequences of liberal lunacy.
Just let them die? Yes, isn’t that what Obamacare would/will do to them? Seriously, in the Obama world of “resource rationing” these people would be expendable. The Death Panel would just pull out their point and figure card and quickly come to the conclusion that there is no justification for “maintaining them” in their current condition. O course there would likely be some leeway or exemptions for “Holder’s People.”
It's almost like institutionalizing but with a friendly face.
Doing away with institutions is yet another "progressive" success story. /s
Oh, you’ll never the Libs’ sticky fingers out of the taxpayer’s cookier jar in any of this. Although wet houses and even wet islands could be operated quite efficiently by private charity.
This is the great benefit of our federal system. If San Francisco wants to turn itself into a giant lunatic asylum and spend tens of millions of taxpayer dollars on homeless junkies to save them from OD’ing time and time again, that is their right. Every homeless junkie in America should move there and let Nancy Pelosi’s husband and a bunch of upper income gay couples support them.
There is no easy solution, because our society has pretty much eliminated the most obvious solutions. My mother tells me stories about one of her great uncles who was a drinker. Wouldn't / couldn't live with the family. He lived in missions and boarding houses or where ever he ended up. Who took care of him? Well, his 6 siblings would try to make sure he got clothes, or medicine. The local cops made sure he wasn't on the street at night, and The Catholic Church provided a place to sleep and meals.
Our society is making sure that the Gov't will be the only to take care of such people.
I used to live there and have been back semi regularly. It's a much different place than the late 80’s. The homeless have become emboldened and are filthy parasites.
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